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Depressed children and the social and behavioral attributes of their best friend

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Depressed children and the social and behavioral attributes of their best friend

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DEPRESSED CHILDREN AND THE SOCIAL AND BEHAVIORAL
ATTRIBUTES OF THEIR BEST FRIEND
Copyright 2001
by
Deborah Chien
A Thesis Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
MASTER OF ARTS
(PSYCHOLOGY)
December 2001
Deborah Chien
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UMI Number 1411019
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U N IV ER SITY O F S O U T H E R N C A L IF O R N IA
T H E G R A D U A T E S C H O O L
U N IV E R S IT Y P A R K
L O S A N G E L E S . C A L IF O R N IA 0 0 0 0 7
This thesis, written by
under the direction of hjEu.t~..T he sis Committee,
and approved by all its members, has been pre
sented to and accepted by the Dean of The
Graduate School, in partial fulfillment of the
requirements for the degree of
D i« t
P air December 17. 2001
M ITTEE
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Table of Contents
List o f Tables................................................................................................................... iii
Abstract.............................................................................................................................iv
Introduction........................................................................................................................I
Method...............................................................................................................................6
Results.............................................................................................................................. 10
Discussion........................................................................................................................14
References........................................................................................................................20
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ii i
List of Tables
Table I: Correlations Among Social and Behavioral Adjustment Variables II
Table 2: Correlations Between Children’s Depression and Attributes of Their Best
Friends and Nonfriends.................................................................................................13
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IV
Abstract
Research has supported the linkages between children’s depression and
indicators of social maladjustment. Less is known, however, about the dyadic
friendships of children with depressive symptomatology. This study sought to
investigate the association between children’s depression levels and the attributes of
their best friends. Data was collected from 353 elementary school children at two
schools in the Los Angeles area, and included self-reports, peer nominations, and
teacher reports. Results suggested that children’s depressive symptoms were
positively associated with their best friend’s depression levels. Children’s self-
reported depression was also correlated with teacher reports of their best friend’s
hyperactivity and lack of prosocial behavior.
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I
Introduction
Most adult-focused models of depression acknowledge the critical role of
interpersonal factors in maintaining depressive symptoms. Depressed individuals
tend to induce negative affect and even rejection in the people with whom they
interact (Coyne, 1976a; Coyne, 1976b; Gurtman, 1986), which in turn reinforces
doubts about self-worth and exacerbates depressive symptomalogy (Coyne, 1976a;
Coyne, 1976b). Research on childhood depression has yet to be strongly influenced
by such interactional models. However, there is a substantial body of evidence that
children who are depressed experience a range of difficulties with peer relationships
and social behavior. Children who suffer from depression are more likely to be
socially withdrawn, rejected, and bullied by their peers (Boivin, Hymel, &
Bukowski, 1995). They are also less likely to engage in prosocial behavior (Altmann
& Gotlib, 1988). Furthermore, depression in childhood is associated with aggression
and other externalizing behaviors (Blumberg & Izard, 1985; Cole & Carpentieri,
1990; Jacobson, Lahey, & Strauss, 1983; Quiggie, Garber, Panak, & Dodge, 1992).
Despite strong evidence that depressed children are at risk for social
maladjustment in the peer group, relatively little is known about the dyadic
friendships of depressed children. Interpersonal models o f development as well as
interactional models o f depression support the importance o f studying such
friendships. According to Sullivan’s (1953) interpersonal theory of development,
friendships are necessary for healthy development because they provide
opportunities for children to leam effective social behaviors. These relationships
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2
play a critical role in social development, and may offer children a level of emotional
support that cannot be obtained within the context of social interactions in the peer
group (Sullivan, 1953). From an interactional perspective, the loss of developmental
opportunity represented by impairments in the ability to form or maintain supportive
friendships could reinforce the cycle of depressive symptoms.
The current investigation aimed to build on existing research on the social
relations of depressed children by focusing on children’s dyadic best friendships.
We expected to replicate previous findings that children’s depression is associated
with behavioral and social maladjustment with peers. We also sought to examine
associations among children’s depression, ability to form and maintain best
friendships, and attributes (i.e., depressive symptoms, behavioral characteristics, and
peer group adjustment) o f their best friend.
Depression may influence the friendships of depressed children in two
important ways. First, as suggested by the interactional model of depression, the
maladaptive social behavior associated with depression may impair children’s
functioning in dyadic relationships as well as in the larger peer group. Therefore, the
current investigation sought to examine the impact of depression on children’s ability
to form dyadic best friendships. We expected that high levels o f depression in
children would be negatively associated with children’s likelihood of having a best
friend.
A second important aspect to consider is the relation between depression and
the characteristics of children’s friends. A large body of evidence suggests that
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3
children and their friends are often similar (e.g. Haselager, Hartup, Van Lieshout, &
Riksen-Walraven, 1998; Kupersmidt, DeRosier, & Patterson, 1995; Rubin, Lynch,
Coplan, Rose-Krasnor, & Booth, 1994). Particularly relevant to this investigation
are studies that demonstrate that children tend to be similar to their friends along
dimensions of behavioral maladjustment. Children and their friends exhibit similar
levels o f withdrawal and aggression (Caims et al., 1998; Kupersmidt et al., 1995;
Haselager et al., 1998), and some researchers have found that adolescents and their
friends display similarities in the use of illegal drugs (Kandel, 1978a). These
findings are consistent with a long tradition within social psychology that identifies
similarity as an important basis for interpersonal attraction (e.g. Burgess & Wallin,
1943; Newcomb, 1956). There is also evidence that patterns o f similarities between
friends stem from processes of both socialization (fnends influence one another) and
selection (individuals choose friends who have similar characteristics) (Kandel,
1978b).
The possible link between depression and the characteristics of a child’s
friends is critical to explore because the developmental significance of a friendship is
at least partially dependent on the behavioral and psychological characteristics of a
child’s friends (Hartup & Stevens, 1999). Well-adapted and socially skilled friends
can serve a buffering or protective role (Kandel & Andrews, 1986). For example,
relationships with prosocial, cooperative children can help a child to improve his or
her own social competence. In contrast, having aggressive or conduct-disordered
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4
friends may place a child at risk for learning antisocial behaviors (Bemdt & Keefe,
1995; Dishion, Andrews & Crosby, 1995; Dishion, Patterson & Griesler, 1994).
We expected that depressed children would form friendships with other
children who are also depressed and socially maladjusted, a tendency which may
pose an additional risk for their social development. Consistent with the
hypothesized pattern o f homophily, there is some preliminary evidence for
consistency in levels of depression within friendship dyads. For example, research
conducted with Dutch elementary school children has shown that friends are more
similar in self-reported depressive symptoms than nonfriends (Haselager et al.,
1998). In addition, Hogue and Steinberg (1995) found that levels o f internalized
distress among adolescent friends (operationalized as unilateral liking nominations;
for a discussion o f the limitations inherent in such approaches, see Furman, 1996)
were modestly correlated. The present study sought to extend this line of research to
examine similarities of children’s depression levels among reciprocated best friends.
We hypothesized that levels of depression in children would be positively associated
with levels of depression in their best friend.
The present study also sought to examine the social behavior and peer group
adjustment of the best friends o f depressed children. Currently, there is a shortage of
empirical evidence addressing this issue. If depressed children themselves are less
likely display prosocial behavior and more likely to be withdrawn, aggressive, and
rejected and victimized by peers, it may be the case that the friends o f depressed
children are similarly maladjusted in their social functioning. It was hypothesized
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that levels of depression in children would correlate with social difficulties of their
best friend—including lower levels of prosocial behavior and higher levels of
withdrawal, rejection, peer victimization, aggression, and other externalizing
behaviors.
In examining the friendship patterns of depressed children, we also
considered the potential moderating role of gender. Several theorists have explored
gender differences in the roles that friends play in children’s social development
(e.g., Maccoby, 1990). Additionally, there is evidence that girls contend with a
higher frequency of risk factors for depression (reviewed in Nolen-Hoeksema &
Girgus. 1994). Therefore, it may be the case that gender influences the friendships
of depressed children. Although a hypothesis regarding gender differences was not
formulated, this study explored the possible role o f gender in associations between
children’s depression levels and the attributes of their best friend.
In part because depression is positively associated with exposure to
community violence and other urban stressors (Kliewer. Lepore. Oskin. & Johnson,
1998; Lynch & Cicchetti, 1998; Martinez & Richters, 1993; Singer, Anglin, Song, &
Lunghofer, 1995), the current investigation was conducted with an inner-city,
ethnically diverse sample. We chose to focus on middle childhood because many
social problems, such as aggression and peer victimization, are known to stabilize
during this period (e.g., Eron, 1987; Olweus, 1979). This age range also precedes
adolescence, in which prevalence rates of depression increase dramatically (Rutter,
1986).
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In summary, the present study aimed to examine associations between
depression and dyadic best friendship patterns in middle childhood. It was
hypothesized that children’s depression would be associated with withdrawal, peer
rejection, peer victimization, externalizing behaviors including aggression and
hyperactivity, and a lack of prosocial behavior. It was also hypothesized that
children’s depression levels would be negatively associated with their likelihood of
having a reciprocated best friend. Furthermore, it was hypothesized that depression
levels between best friends would be correlated, and that children’s depression
would be associated with other attributes of their best friend, including withdrawal,
peer rejection, peer victimization, aggression, hyperactivity, and a lack of prosocial
behavior. Finally, the possible moderating role of gender was explored in all of the
above areas of investigation.
Method
Participants
532 third, fourth and fifth grade children from two public elementary schools
in Burbank were asked to participate in the study. Burbank is an incorporated city
located approximately 10 miles north of central Los Angeles. This area of the
Southern California region is currently experiencing a moderate degree of economic
stress, with approximately 15% of households having incomes below federal poverty
levels and about 40% of households subsisting on incomes less than 535,000 a year
(United Way o f Greater Los Angeles, 1999).
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Parental consent was obtained for 75% of the children. Among those whose
parents who did not consent, 84 parents declined and another 48 did not reply. Of
those children who obtained parental consent, 27 were not included in the analyses
because they took part in a special education program. The final sample consisted
o f 353 children (mean age = 9.0 years; 51% girls, 49% boys) who participated in the
study. The ethnic/racial breakdown of the sample was as follows: 29% European
American, 39% Hispanic American, 5% Asian American. 2% African American, and
24% other.
We were able to obtain some limited information on non-consenting children,
including addresses (rounded to the nearest city-block so that specific children could
not be identified) and standardized achievement test scores. This information was
provided by school administrative staff in a data file that did not contain names.
Consenting and non-consenting children were distributed with similar frequencies in
the census tracts surrounding the school (i.e., they lived in the same neighborhoods).
Assessment of Internalized Distress
Depression. Children completed the Child Depression Inventory (CD I;
BCovacs, 1981), a commonly used measure of depressive symptoms in children used
in both research and applied settings. The CDl is a 27-item questionnaire; for each
item, children endorse one of three statements about themselves reflecting varying
levels of cognitive, affective and somatic symptoms of depression. The item
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assessing suicidal ideation was omitted from the questionnaire because of university
administration concerns. Items are rated on scale from 0 to 2, indicating symptom
severity, and this adapted scale yields a total score ranging from 0 to 52. Internal
consistency (a = 89 in current sample) and test-retest reliability (test-retest
correlations range from .38 to .87 depending on specific sample and time interval;
Kovacs, 1992) have been shown to be adequate for this measure of depression in
children. Good discriminant validity has been demonstrated when classifying
children with no significant psychopathology versus depressed children (Kovacs,
1992).
As will be discussed later, a subset of the dataset was used to analyze
depression levels of those participants who had a reciprocated best friendship. The
CDI scores of children who had a best friend (n = 86) and those who not (n = 260)
did not differ in their CDI levels, t (344) = .41, ns.
Assessment o f Peer Relationships
Children’s Friends and Nonfriends. Children were given lists of names of
their classmates, and were asked to nominate a best friend and four other friends
from the list.1 A relationship between two children was considered a reciprocal
friendship if both children nominated each other as friends. Dyads in which both
children nominated each other as best friends were considered reciprocal best
friendships. Only same-sex dyads were analyzed.
1 The average number of children per class was 21.
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O f each best friend dyad, one child was randomly selected to be the target
child. For the purpose of comparing similarities between friends to similarities in
other dyads, each target child was matched with a randomly selected, same-sex child
from the same classroom, who was designated a “nonfriend.” In each case, neither
the nonfriend nor the target child nominated the other as either a best friend or
friend.
Social Preference. Acceptance or rejection by peers was assessed by asking
children to choose up to three peers that they liked, and up to three peers that they
disliked. The total number of “like” and “dislike” nominations received by each
child was then calculated, and standardized within classrooms. A social preference
score, which served as an index of peer rejection, was then calculated as the
standardized difference between the “liking” and “disliking” scores (as per Coie.
Dodge, & Coppotelli, 1982).
Assessment of Behavioral Outcomes
Children’s Social Behavior. Teachers completed the Child Social Behavior
Rating Scale (Schwartz, 2000), a 40-item questionnaire using a 5-point rating scale
with responses ranging from “never true” to “almost always true.” With pilot data,
the scale yielded scales that assess aggression (e.g.. “starts fights with other
children,” “hits and pushes other children,” a = .86), attention deficit and
hyperactivity (e.g., “difficulty sustaining attention to tasks.” “has difficulty
remaining seated,” a = .85), submissiveness-withdrawal (e.g.. “gets bossed around
by peers,” “avoids social contact with peers,” a = .73), assertiveness-prosociabilitv
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(e.g., “initiates social contact with peers,” “assertive and stands up for self without
using aggression,” a = .88), and peer victimization (e.g., “other children hit or push
this child,” “other children ignore this child to be mean,” a = .89).
Procedure
Parents of all third, fourth- and fifth-graders in the two participating schools
were sent permission slips that indicated informed consent for their children to
participate in the study. Child self-report and peer-nomination measures were
administered by trained graduate students, who read standardized instructions to the
children, and then read each questionnaire item aloud. Children were asked to remain
silent during administration to reduce the influence of social desirability on their
responses. All questionnaires were administered in English only, although Spanish
speaking teachers and teacher-aids were available in case any of the children had
language difficulties. Measures were administered in random order.
All teachers of participating classrooms were asked to complete
questionnaires for each child who obtained parental consent. Teacher measures were
completed within a two-month period following administration o f the child
measures. Teachers were paid S50.00 for their participation.
Results
Relations between Children's Social and Behavioral Adjustment Variables
Intercorrelations were computed among all social and behavioral adjustment
variables, as presented in Table I.
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Correlations Amonu Social and Behavioral Adjustment Variables
1 2 3 4 5 6 7 8
1. Has a best friend?
2, Teacher rated peer victimization -0.20***
__
3. Teacher rated assertion 0.17* -0.55***
4, Teacher rated withdrawal -O.I4t 0.59*** -0.55***
5. Teacher rated aggression -0.15 | 0.67*** -0.49*** 0.21***
_
6, Teacher rated hyperactivity -0.15t 0.64*** -0.59*** 0.34*** 0.65***
_ _
7, Social preference 0.29*** -0.35*** 0.31*** -0.17* -0.31*** -0.37***
8. Self rated depression -0.10 0.27*** -0.29*** 0.27*** 0.16* 0.25*** -0.16*
Note. Critical levels are set at .005 to control error rales,
t p < .05 (marginally significant). * p < .005. ♦♦ p < .001. *** p < ,0005.
12
The hypotheses regarding children’s depression and social adjustment were
consistently supported. Children with higher levels o f depression were more likely
to be withdrawn, victimized and rejected by their peers, and less likely to display
assertive, prosocial behavior. Depression was also found to be associated with
externalizing behavior, including aggression and hyperactivity.
As hypothesized, there was a small but significant relationship between
depression level and whether or not the child had a reciprocated best friend.
These correlations were also conducted separately for boys and girls. Tests
of differences (conducted by transforming correlation coefficients to Fisher z scores)
between the two groups did not yield significant results.
Children’s Level of Depression and Best Friend’s Level of Depression
To test the hypothesis that children’s depression would be similar to their
best friend’s depression, correlations were conducted between these variables. Half
of the 82 children who had reciprocated best friends were randomly selected to be
the “target child,” resulting in 41 best friend pairs. McGraw and Wong (1996)
recommended that when analyzing data in which the same variable (in this case,
depression) is being compared within pairs of exchangeable units (best friends),
intraclass correlations should be computed rather than the standard Pearson’s
product-moment correlation. Results o f the intraclass correlations can be interpreted
in a similar fashion to the Pearson’s r. Therefore, an intraclass correlation was
computed for this analysis. As shown in Table 2, results supported the hypothesis of
homophily, indicating that children’s level o f depression was significantly associated
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with their best friend’s depression level. In contrast, the correlation of depression
levels between target children and their nonfriends was not significant. Correlations
between friends and nonfriends were compared using a formula for dependent
correlations (Meng, Rosenthal, & Rubin, 1992).
These same correlations were also conducted separately for boys and girls.
However, differences in patterns did not emerge at statistically significant levels.
Table 2
Correlations Between Children’s Depression and Attributes of Their Best Friends and N'onfriends
Attribute Correlation Correlation
With Best Friend With Nonfriend
1. Depression1 * .30* .05
2.
Teacher-rated Withdrawal .09 -.11
3. Teacher-rated Peer Victimization .10 .02
4. Teacher-rated Aggression .10 .05
5. Teacher-rated Hyperactivity .25+ .03
6. Teacher-rated Assertiveness -.25+ .05
7. Social Preference -.07 -.09
Note, t p < .05 (marginally significant). * p < .005.
T o r this analysis, n = 41; an intraclass correlation was computed. All other analyses used a Pearson's
r, and the full sample of 32 pairs.
Children’s Level o f Depression and Best Friend’s Other Attributes
Correlations were also calculated between children’s depression and
indicators o f their best friend’s social adjustment. These remaining analyses were
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conducted using the Pearson r, and the full sample o f 82 pairs of best friends was
used to explore the relationship between children’s depression and other attributes of
their best friends2. The hypothesis that children’s depression levels would be
associated with the social maladjustment of best friends was partially supported.
Shown in Table 2, results revealed that higher levels of depression were related to
lower levels of prosocial behavior among their best friends. Furthermore, children’s
depression was also correlated with their best friend’s level of hyperactive,
externalizing behavior. While these findings are significant at the marginal level,
they are strengthened somewhat by the fact that the same analyses with nonfriends
found no significant relationships.
However, results did not indicate a correlation between children’s depression
and best friends’ level of social preference, withdrawal, aggression, peer rejection, or
peer victimization (see Table 2).
Again, additional analyses were conducted separately for boys and girls, but
tests comparing correlations between the two groups did not yield statistically
significant differences.
Discussion
The present investigation extends the existing literature on children’s
depression and interpersonal relationships by suggesting that there is an association
between children’s depression and the social maladjustment of their best friends.
1 The actual sample size varied across analyses, with no more than 3 subjects missing data in
any analyses.
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While a limited number of studies have investigated the similarity of depression
levels among friends in childhood, the current study explored additional avenues of
homophily between depressed children and their friends. A particular strength of
this study was that measures of children’s self-reported depression were analyzed
with peer-nominated measures of social preference and teacher-rated social
behavioral ratings, thereby reducing the influence of reporter bias. The study was
also important because it focused on an economically stressed urban sample, in
which children may be at higher risk for depression (e.g., Martinez & Richters,
1993). Furthermore, it differed from past studies because the unit of analysis was
reciprocated best friendships, rather than unilateral friendships (as in Hogue &
Steinberg, 1995).
Relations between Children’s Social and Behavioral Adjustment Variables
Consistent with results from numerous other studies (e.g. Boivin, et al., 1995;
Altman & Gotlib, 1988), children reporting greater depressive symptomatology were
also rated by their teachers as more withdrawn, aggressive, hyperactive, victimized
by their peers, and less likely to behave prosocially. They were also more likely to
be rejected by their peers, as indicated by peer nomination measures. Moreover,
depression in children was associated with a lower likelihood of having a
reciprocated best friend.
Children’s Level of Depression and Best Friend’s Level of Depression
As hypothesized, analyses of best friend pairs yielded patterns o f similarity of
depression, as indicated by a moderate association between children’s level of
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depression and their best friend’s level of depression. This finding was consistent
with other studies that have examined this relationship with samples of different
demographics (i.e., a European sample of children (Haselager et al., 1998)) or with
an alternative methodological approach (Hogue & Steinberg, 1995). Thus, results of
this study extend the generalizability of existing evidence that children tend to have
best friends who are similarly depressed.
Children’s Level of Depression and Best Friend’s Other Attributes
In addition to having friends who tended to be depressed, children who
scored for higher depression also had friends who were socially maladjusted in other
ways. Children’s depression levels were found to have small to moderate
associations with their best friend’s level of hyperactivity and lack of prosocial
behavior.
The finding that depressed children have friends who are socially
maladjusted indicates a pattern that could pose a risk for these children. Past studies
have demonstrated that homophily may be attributable both to socialization effects—
children influencing friends—and to selection effects—children choosing friends
who are similar to them (e.g. Kandel, 1978a). Either hypothesized explanation may
contribute to the continuation or worsening of children’s depression and social
difficulties. For example, the mutual influence between antisocial boys and their
friends has been shown to lead to increasingly negative outcomes, as boys ‘Team”
new antisocial behavior from their friends (Dishion et al., 1995). And to the extent
that depressed children may also be selecting friends who are similarly depressed
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17
and socially maladjusted, they are limiting their opportunities to form dyadic
relationships with prosocial children. Rather than providing contexts for
improvement of social competency, these socially impaired and behaviorally
dysregulated friends may hinder children’s social development. Furthermore, the
association with other depressed children may reinforce these children’s own
depression, creating a self-perpetuating cycle as described by Coyne (1976a).
Limitations
While the present results provide compelling evidence for a potentially risky
friendship pattern among depressed children, it is important to acknowledge the
limitations of the study. Because of the cross-sectional design of this investigation,
causal relationships could not be established. While results from this investigation
paint a vivid descriptive picture of the dyadic relationships of children with
depressive symptomatology, less is known the dynamic processes underlying this
picture. From these results, it is unclear to what extent the patterns of similarity
between best friends are attributable to children selecting friends who are like them,
and to what extent they are influenced to become like their friends.
This study was also limited by its modest sample size. Although the original
sample size was 353 children, our central analyses focused on best friendships, and
only about a quarter of the original sample had reciprocated best friends. This
sample size may have hindered the detection of some of the correlations between
depression in children and their best friends’ attributes, including withdrawal, peer
rejection and victimization, and aggression. Gender differences were also not
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detected. It is possible that with an expanded sample size, relationships between
some of these variables would emerge.
Another limitation was that children were allowed to nominate best friends
only within their classroom. Had they been given a broader option of children (e.g..
children from other classes), some children might have nominated friends to whom
they felt closer. If the level of similarity between friends is associated with the
degree o f intimacy within the friendship, and some children had close friends outside
the classroom, the inclusion of those friends may have strengthened the results.
Conclusion
In summary, depressed children in the present investigation had best friends
who were also depressed, behaviorally dysregulated and lacking in prosocial
behavior. This pattern points to a risky developmental trajectory for depressed
children, in which they are caught in friendships that may expose them to others who
display the same difficulties they themselves have. Directions for future research
include designs that follow children and their friends over time, to determine the
effects of socialization versus selection. Longitudinal research on this issue is
particularly important for children in middle childhood, as this age group precedes
the adolescent phase, in which risk for depression increases dramatically (Rutter,
1986). If being friends with similarly maladjusted children keeps depressed children
in a vicious cycle of maintaining or worsening depression, it is important that efforts
to intervene include assessment of the characteristics of children’s friends.
Treatment programs designed to help children who suffer from depression should
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19
include a focus on children’s friendships as a critical environmental factor that may
contribute to their depression.
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2 0
References
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Boivin, M., Hymel, S., & Bukowski, W.M. (1995). The roles of social
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Burgess, E.W., & Wallin, P. (1943). Homogamy in social characteristics.
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Caims, R., Caims, B., Neckerman, H., Gest. S., & Gariepy. J.L. (1988).
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Asset Metadata

Creator Chien, Deborah Hsiayi (author)

Core Title Depressed children and the social and behavioral attributes of their best friend

School Graduate School

Degree Master of Arts

Degree Program Psychology

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag OAI-PMH Harvest,Psychology, clinical

Language English

Contributor Digitized by ProQuest (provenance)

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Permanent Link (DOI) https://doi.org/10.25549/usctheses-c16-290977

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